Medical-inadmissibility

Who can be found to be

Medical Inadmissibility

All applicants for permanent residence in Canada, and in some cases applicants for visitor visas, study permits and work permits too, are required to undergo medical examination by authorized physicians (known as “panel physicians”).  It is typically the results of such mandatory medical examinations which trigger a determination that an applicant might be medically inadmissible to Canada.

The Immigration and Refugee Protection Act sets out that a foreign national, which is anyone who is not a Canadian citizen or permanent resident, can be found medically inadmissible by reason of a physical or mental condition which can reasonably be expected to:

  • Pose a danger to public health;
  • Pose a danger to public safety; or
  • To cause excessive demand on health or social services.

Likely danger to public health of Canada

Very few medical conditions fall under this category.  It is restricted to highly contagious diseases.  For example, foreign nationals carrying active tuberculosis or active syphilis will be determined to be inadmissible.

Likely to be a danger to public safety

Equally few medical conditions are likely to endanger Canadian public safety.  Mental health conditions which might be the cause of violent, antisocial behaviour could be expected to be grounds for medical inadmissibility.

Excessive demand on health or social services

Determinations of inadmissibility for excessive demand can result from 1 of 2 separate assessments: 1) the foreign national’s need for medical services will negatively affect current wait times in Canada for said services; or 2) the services required to treat and manage the foreign national’s health condition will cost more than 3 times the Canadian per capita cost for health and social services over a 5-year period (or 10, if significant costs are likely to be incurred).

For the calendar year 2019 the inadmissibility threshold was set at CAD $102,585 over 5 years (or $20,517 per year).  These costs are updated every year based on average per capita health care costs in Canada.

How can The Principals Immigration Services help?

If you have received a procedural fairness letter from IRCC advising you that you might be inadmissible on grounds that you have, or a family member has, a medical condition which might cause excessive demand on Canada’s public health services, there are two possible ways in which The Principles Immigration Services could help you challenge the officer’s concerns:

  1. It may be possible to establish that the officer was wrong on the facts, and that the medical condition of the applicant will not require medications, therapies and medical care whose costs over five years will not cross the threshold of excessive demand. If appropriate in the circumstances of the applicant, this approach requires re-examination of the allegedly inadmissible client by independent, and usually specialist, physicians and therapists.  On the basis of the results of re-examination, the costs of the applicant’s projected requirement for medications, therapies and medical care over a period of five year can be recalculated.  If recalculation brings those costs under the excessive demand threshold, the case has been made that the applicant is not inadmissible.

  2. Following a decision of the Supreme Court of Canada (Hilewitz v. Canada, 2005, SCC 57), it is possible to overcome the inadmissibility of an applicant even where the projected costs of his medications, therapies and medical care over a period of five years, by demonstrating that the applicant has the resources to pay for his or her care independently of public health care services. In such cases, the response to the procedural fairness letter will be a detailed and documented practical and financial plan which demonstrates the ability of the applicant to meet his or her medical requirements without exceeding the excessive demand threshold.   In this way too, the case has been made that the applicant is not inadmissible.

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